presented by ms.chitra iyer, chetna and change partners, rajasthan
DESCRIPTION
Enhancing access to NRHM entitlements: CHETNA’s efforts in five districts of Rajasthan ( April 2010- July 2011). Presented by Ms.Chitra Iyer, CHETNA and CHANGE partners, Rajasthan. Rationale. - PowerPoint PPT PresentationTRANSCRIPT
Raising Consciousness Creating Awareness
Enhancing access to NRHM entitlements: CHETNA’s efforts in five
districts of Rajasthan ( April 2010- July 2011)
Presented by Ms.Chitra Iyer, CHETNA and
CHANGE partners, Rajasthan
11 August, 2011
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• The National Rural Health Mission (NRHM) is GoI flagship programme launched in 2005 to enhance access to quality health services from the public health system, particularly rural poor women and children
• The NRHM covers the entire country, with special focus on 18 states. Rajasthan is one of the EAG states with high MMR (335 per 100,000 live births) and NMR (35 per 1000 live births) – DLHS 2008
• Building capacities of ASHAs to facilitate access to health services is one of the key strategies of NRHM
Rationale
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• Communication for Health Advocacy in National Rural Health Mission for Grass root Empowerment (CHANGE) project aims to complement the government’s NRHM efforts by strengthening community mobilization and focuses on increasing access to quality health and nutrition services
Communicating for CHANGE
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• To ensure community access to quality health and nutrition services
Goal of the Project
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• Development of a participatory communication strategy to advocate for health entitlements of rural communities.
• To enhance capacity of the service providers, civil society orgnizations, media and PRI on communicating and advocating for NRHM commitments.
• To promote community awareness on MCH entitlements.
• To promote exchange of experiences, innovations, learning and challenges.
• To document and disseminate key processes and learning.
Project Objectives
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Coverage and Partners
Churu
Alwar
Karauli
Udaipur
Banswara
Akhil Bharitya Gramin Utthan Samiti
Aravali Serva Sewa Farms
Shikshit Rojgar Kendra Prabandhak Samiti
Education Conscientisation, Awareness and Training Bodhgram
ALERT Sansthan
Total no of Villages: 794
Total population: 9,74,430
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Mobilizing communities to access Maternal and ChildHealth (MCH) entitlements by :• Participatory Needs Assessment (PNA)
• Development of participatory communication strategies
• Capacity building of local stakeholders in the intervention block
• Advocacy through creating spaces for dialogue and learning among different stakeholders
Project Strategy
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Needs identified through PNA conducted in May 2010 with 2269community members/ASHAs/VHSC/PRIs and Service ProvidersCommunity needs: 1800 pregnant and lactating women and
communitymembers expressed the need for:• Information on services/public health• Appropriate tools to access information• One point person at village level for information source on access
to services• Regularity of the visit of frontline workers ASHA’s needs• 227 ASHAs expressed the need for clarity on :• Their roles and responsibilities and that of ANM/AWW• Information on MCH entitlements/schemes/Government
Resolutions• Communication material for education and counselling community
Needs identified
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Needs of VHSC/PRI148 VHSC/PRI members expressed the need for clarity
ontheir roles and responsibilities, untied funds and its
use
Needs of PHC staffFocus Group Discussion and Key Informant Interview
with 94PHC staff revealed the need for• Clarity on NRHM programme and MCH entitlements• Their role to facilitate access to MCH services
Needs identified
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Community mobilisation
Community Awareness
meetings with 22000
community members
(pregnant and lactating women,
adolescent girls and men)
Celebration of thematic days (International Women’s Day, Breast feeding week, World Health Day)
Through local fairs (kaila
Devi/Gangaur/Baba
Gaugandas fair)
Government initiatives (Swasthya
Chetna Yatra, Prasasan Gaun
ki aur)
MCHN day at sub centre
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Motivating communities to access the services• Partners oriented 581 ASHAs on MCH entitlements
and their role as key communicator to inform and motivate the community members to access services
• Partners oriented 400 VHSC members oriented on MCH entitlements, untied fund and its use and their role in monitoring the health services
Capacity building
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Creating spaces for dialogue to ensure servicesObservation of MCHN days and joint meetings withASHA/ANM/AWW to establish linkages for health andnutrition servicesProvide mentoring support to ASHAs on monthly
meetings toenable her share her concernsParticipation in block/district/PHC meetings, one to
onesharing with Block Program Manager/Block ASHA
Advocacy
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Community level:• Enhanced awareness about MCH entitlements and started
accessing services• More no. of women have started accessing services such as
institutional delivery and referral transport• More no. of children coming to the AWC for getting immunized• More no. of women, adolescent girls and children participating
in MCHN days
Changes observed..
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• At ASHAs level• Enhanced confidence • Started sharing her issues/concerns in PHC sector meetings• Enhanced rapport with community/service providers• Increased motivation to mobilize and share information on
MCH entitlements to the community• Service providers level• Enhanced clarity about their roles and responsibilities• Initiated to invite project team in sector/PHC meetings to
share the field realities and support the partners accordingly• Regular follow-up by the partners and support by the Block
Officials has led to recruitment of ASHAs (34) at Karauli and Tijara block
• Regularisaton of services at Anganwari centre (10), sub-centre (10) and PHC level
CHANGES observed
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• Regular refresher training and mentoring support to ASHA
• Institutionalization of ASHA within the system• Attention to training quality and systems,
recruitment and timely payment to ASHAs would enable her to play a key role in motivating the community to access health and nutrition services
• Regular communication with community and with ASHAs
• Increased about entitlements among communities has brought a shift from access of private health services to public health services
Lessons learnt